R-LC angles ranged between -38° and +35°. The mean R-LC angle was -0.3° ± 15.9° and its 95% confidence interval was [-4.0°, 3.3°] within [-15°, + 15°]. When indicating lesion locations as times on a clock face, there may be an error of ±30 min (±15°); therefore, R- and LC-lines were demonstrated to be identical using an equivalence test. CONCLUSIONS Using this method, the circumferential position of small lower esophageal lesions may be reliably represented as a clock face.BACKGROUND Cancer diagnoses are increasing rapidly due to the aging population of Japan. Pedicle sign is a valuable radiographic indicator of metastases as the pedicle is the most commonly affected part of the vertebra upon radiographic assessment. However, few detailed studies examining the morphological features of pedicle signs have been performed. To improve the capacity of medical professionals to diagnose symptomatic spinal metastases, we retrospectively examined the morphological characteristics of pedicle signs and their relationship with clinical and radiological features. METHODS In total, 186 patients with symptomatic spinal metastases who visited our department between January 1, 2011, and December 31, 2017, were enrolled in the study. Pedicle sign was defined as a pedicle that had disappeared or had become obscured on an anteroposterior radiographic image. Radiographic images were evaluated for pedicles and other structures of the vertebrae. Clinical and other radiological features were compared among the types of pedicle signs identified. RESULTS Pedicle signs were classified according to whether they had completely disappeared (complete type, 26 patients), partially disappeared (partial type, 40 patients), or were obscured by the osteoblastic background (blastic type, 28 patients). The disappearance of the bone cortex in addition to the pedicle was observed in almost half of the patients with complete and partial types of pedicle signs. Complete types were associated with significantly longer survival rates. CONCLUSION Understanding of the various types of pedicle sign is required to properly diagnose bone metastases.PURPOSE The aim of this study was to measure the serum levels of brain-derived neurotrophic factor (BDNF) in primary open angle glaucoma (POAG) and normal tension glaucoma (NTG) patients in Japan. METHODS This was a prospective, observational study that examined serum BDNF levels in 78 patients who underwent cataract surgery or trabeculectomy (27 glaucoma patients and 51 non-glaucoma cataract patients as controls). The patients' age was 68.8 ± 11.1 years (mean ± standard deviation; range 35-86 years). The number of patients with POAG and NTG was 16 and 11, respectively. The diagnosis of POAG was done by intraocular pressure measurement, gonioscopy, optic nerve head change, and the presence of a visual field defect. RESULTS The serum BDNF concentration was significantly lower in the glaucoma group, including both POAG and NTG, than in the control group (7.2 ± 3.6 ng/mL vs. 12.2 ± 9.3 ng/mL, p=0.004). The serum BDNF concentration was lower in the early phase than in the moderate phases of glaucoma. There was no correlation between the serum BDNF concentration and age. When the NTG and POAG patient groups were compared, the serum BDNF concentration was lower in NTG patients than in POAG patients. No significant correlations were found between glaucoma parameters, including optical coherence tomography and visual field defects, and the serum BDNF concentration. CONCLUSION This is the first study to have investigated serum BDNF concentrations in glaucoma patients in Japan. Further investigations are needed to evaluate the role of BDNF as a potential biomarker of glaucoma.BACKGROUND Transfer of infants who no longer need intensive or specialized care from tertiary to community hospitals or clinics contributes to efficient bed utilization in neonatal intensive care units (NICUs). METHODS A retrospective analysis of the records of all 1,503 infants admitted to our NICU during the past 6 years (from April 2013 to March 2019) was performed to evaluate the impact of interfacility neonatal transport for convalescent care. RESULTS During the study period, our NICU accepted 33 infants from other tertiary NICUs and transferred 103 infants to other hospitals or clinics before their home discharge for convalescent care. https://www.selleckchem.com/products/8-cyclopentyl-1-3-dimethylxanthine.html Our NICU covered 39% of the total hospital days of infants accepted from other NICUs. Of the infants transferred to other facilities, 81% of infants born at our hospital were born to mothers transported to our obstetric department as imminent high-risk deliveries; 94% of infants born at other hospitals were moved back to the referring facility. CONCLUSIONS Interfacility neonatal transport for, both accepting and transferring infants for convalescent care has become an integral part of NICU practice to bridge the gaps between higher level care facility and home. Establishment of well-defined transfer criteria and appropriate allocation of medical and staff resources among relevant facilities is desirable.BACKGROUND Thrombopoietin (TPO) receptor agonist, Lusutrombopag, is recently released to treat thrombocytopenia in chronic liver disease (CLD). However, its effectiveness remains to be unclear. The purpose of this study was to clarify the efficacy of Lusutrombopag and identify the predictors associated with platelet count increase. METHODS Eighty CLD patients with thrombocytopenia were enrolled. The primary endpoint was the Lusutrombopag effect, which is the proportion of cases satisfying following; the platelet increase was enough (with an increase of greater than 1.0 × 104/μL from at baseline) and platelet transfusion was not required. The secondary endpoints were the response rate (which showed an increase of greater than 1.0 × 104/μL from at baseline), independent predictors of increased platelets, and the superiority of Lusutrombopag over platelet transfusion. RESULTS The primary endpoint was 93.8% (75 of 80 patients). The response rate was 96.2% (77 of 80). Factors indicative of renal function (BUN, creatinine, eGFR) significantly and negatively correlated with increase in platelets (p = 0.033, 0.049, 0.0014, respectively), and were also identified as independent predictors by multiple regression analysis (p = 0.049, 0.0023, 0.0016, respectively). The median increase in platelet count after Lusutrombopag was significantly higher than that after platelet transfusion (41000 vs. 12000 /μL, p = 0.015). CONCLUSION This study revealed that Lusutrombopag was more sufficiently effective in CLD patients compared with platelet transfusion and that renal function is independent predictor of increase. Factors indicative of renal function significantly and negatively correlated with increase in platelets.